Elsevier

The Journal of Pediatrics

Volume 149, Issue 3, September 2006, Pages 373-377
The Journal of Pediatrics

Original article
Hospitalization for respiratory syncytial virus among California infants: Disparities related to race, insurance, and geography

https://doi.org/10.1016/j.jpeds.2006.04.063Get rights and content

Objectives

To evaluate population-based rates of Respiratory Syncytial Virus (RSV)-associated infant hospitalizations related to race/ethnicity, payer source, and geography in California.

Study design

Retrospective analysis of RSV-coded infant hospitalizations were performed using the California patient discharge data for 1999 to 2003. All discharge records for infants younger than 1 year of age with an ICD-9-CM code for any RSV-related illness (466.11, 480.1, or 079.6) among any of the diagnosis fields were selected for analysis (n = 45,330). Rates were expressed as the number of RSV-associated hospitalizations per 1000 live births in the same calendar year.

Results

Infants enrolled in MediCal (California’s version of the United States’ national Medicaid program) had a relative risk of 2.03 (95% CI, 1.99 to 2.06) compared with non-MediCal payers (24.3 vs 12.0/1000 live births, respectively). The 1999 to 2003 rates per 1000 live births of RSV-associated hospitalizations for MediCal payers by race/ethnicity were: non-Hispanic white (34.9), African-American (27.9), Hispanic (21.8), Asian/Pacific Islander (12.5), and American Indian/Alaska Native (12.2).

Conclusions

RSV was the leading cause of infant hospitalizations in California between 1999 and 2003. RSV hospitalization rates were highest among non-Hispanic white MediCal insured infants.

Section snippets

Methods

Retrospective analyses of RSV-coded infant hospitalizations were performed by using the California patient discharge data for 1999 to 2003. All discharge records for infants younger than 1 year of age (excluding newborn infants) with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for any RSV-related illness (466.11, 480.1, or 079.6) among any of the 25 diagnosis fields were selected for analysis. RSV-related illnesses included RSV

Results

RSV bronchiolitis was the leading cause of infant hospitalizations in California between 1999 and 2003 (Figure 1). A total of 45,330 infant RSV illnesses among any of the 25 diagnosis fields were identified from the patient discharge files between 1999 and 2003. Of all infant hospitalizations occurring in California, any RSV illness accounted for 12.8%, 12.0%, 11.6%, 12.7%, and 10.2% between 1999 and 2003, respectively. This represents a rate per 1000 live births of 19.0 (95% CI, 18.6 to 19.4),

Discussion

RSV was the leading cause of infant hospitalization in California each year during the study period (1999 to 2003), with 12% of all infant hospitalizations having an RSV associated illness. Our results are consistent with national data reporting RSV bronchiolitis as the primary cause of hospitalization among infants.8 In California, RSV occurs in seasonal epidemics with peaks occurring in the winter months similar to patterns reported nationally.1, 7, 8, 9, 10 National RSV-associated

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